title: [Clinical and immunological characteristics in pediatric patients with coccidioidomycosis in northeastern Mexico].
abstract: BACKGROUND
  Coccidioidomycosis is a systemic fungal disease caused by Coccidioides spp. Patients with phagocytic, cellular, or humoral immunodeficiencies exhibit immunodeficiencies that confer increased susceptibility to fungal infections. In Mexico there is an underreporting of this disease and no studies currently describe the immune status of these patients in an endemic area.
  
  
  OBJECTIVE
  To describe the clinical and immunological characteristics of pediatric patients with coccidioidomycosis.
  
  
  METHODS
  Pediatric patients with diagnosis of coccidioidomycosis from two tertiary level hospitals of northeastern Mexico were included, from the period 2008-2012; immune status was assessed by clinical history, immunoglobulins levels, levels of lymphocytes T, B, and NK (natural killer), and the nitroblue tetrazolium test.
  
  
  RESULTS
  Thirty patients were included, 18 male (60%). The age at diagnosis was five years (median, range 0.25-13). Twelve were from Coahuila (40%). Residual pulmonary coccidioidomycosis was the clinical type presentation found in 16 patients (53%). A primary humoral immunodeficiency was found in three patients (10%) and a secondary immunodeficiency in another three (10%). Case fatality rate was 16%.
  
  
  CONCLUSIONS
  . The disease predominated in male patients. In 33% of patients, levels of IgG were elevated, probably due to stimulation by chronic fungal infection. In 20% of patients, immunodeficiency was documented. There was a high mortality rate.
authors.affiliation: Servicio de Pediatría de la Unidad Médica de Alta Especialidad (UMAE) n.o 25, Centro Médico Nacional del Noreste, Monterrey, N.L. tamarastaines@gmail.com.
authors.forename: Daniela María
authors.initials: DM
authors.lastname: Cid Chávez
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Ruiz Pedraza
authors.forename: Luz María
authors.initials: LM
authors.lastname: Sánchez Sánchez
authors.forename: Aidé Tamara
authors.initials: AT
authors.lastname: Staines Boone
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Castro Pineda
authors.forename: Gerardo  del Carmen
authors.initials: G
authors.lastname: Palacios Saucedo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003047:Coccidioidomycosis / Q000175:diagnosis* / Q000276:immunology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008800:Mexico